Alcohol Consumption Screening AUDIT Questionnaire

 

1) How often do you drink anything containing alcohol?
		Never (0 points)
		Monthly or less (1 point)
		2 to 4 times a month (2 points)
		2 to 3 times a week (3 points)
		4 or more times a week (4 points)
2) How many alcohol drinks do you have on a typical day?
		1 or 2 (0 points)
		3 or 4 (1 point)
		5 or 6 (2 points)
		7 to 9 (3 points)
		10 or more (4 points)
3) How often do you have 5 or more drinks on one occasion?
		Never (0 points)
		Less than monthly (1 point)
		Monthly (2 points)
		Weekly (3 points)
		Daily or almost daily (4 points)
4) How often in the last year were not able to stop drinking once you had started?
		Never (0 points)
		Less than monthly (1 point)
		Monthly (2 points)
		Weekly (3 points)
		Daily or almost daily (4 points)
5) How often in the last year have not been able to do what was normally expected of you because of drinking?
		Never (0 points)
		Less than monthly (1 point)
		Monthly (2 points)
		Weekly (3 points)
		Daily or almost daily (4 points)
6) How often during the last year have you needed a drink in the morning to get going after a night of heavy drinking?
		Never (0 points)
		Less than monthly (1 point)
		Monthly (2 points)
		Weekly (3 points)
		Daily or almost daily (4 points)
7) How often during the last year have you felt guilty or remorsefull after drinking?
		Never (0 points)
		Less than monthly (1 point)
		Monthly (2 points)
		Weekly (3 points)
		Daily or almost daily (4 points)
8) How often during the last year have you forgotten what happened the night before because of drinking?
		Never (0 points)
		Less than monthly (1 point)
		Monthly (2 points)
		Weekly (3 points)
		Daily or almost daily (4 points)
9) Have you or someone else been injured as a result of your drinking?
		No (0 points)
		Yes but not in the last year (2 points)
		Yes, during the last year (4 points)
10) Has a relative, friend, or health care worker been concerned about your drinking or suggested you cut back?
		No (0 points)
		Yes but not in the last year (2 points)
		Yes, during the last year (4 points)

 

Total Criteria Point Count:
 

 

Alcohol Screen Score

 

0 to 7 Points:	Low risk
8 to 15 Points:	Medium risk
16 to 19 Points:	High risk
20 to 40 Points:	Addiction likely

 

Notes

• Low Risk (0-7 points) You probably do not have a problem with alcohol. Continue drinking in moderation or not at all.
• Medium Risk (8-15 points) You may drink too much on occasion. This may put you or others at risk. Try to cut down on alcohol or stop drinking completely.
• High Risk (16-19 points) Your drinking could lead to harm, if it hasn't already. It's important that you cut down on alcohol or stop drinking completely. Ask your doctor or nurse for advice on how best to cut down.
• Addiction Likely (20+ points) It is likely that your drinking is causing harm. Speak to your doctor or nurse, or an addiction specialist. Ask about medications and counseling that can help you stop drinking. If you are dependent on alcohol, do not stop drinking without the help of a healthcare professional.